Insurers scramble to complete Obamacare enrollments

TimothyW. Martin

ChristopherWeaver

Millions of new insurance policies purchased under the federal health-care law officially take effect on Wednesday, but many enrollees won’t be able to use them to visit doctors or get prescriptions filled for days or weeks, insurers say.

Because problems with the online marketplaces forced the government to extend deadlines for enrollment to Christmas Eve, insurers are hustling now to complete those enrollments, to process payments and to issue membership cards. They say they won’t be able to reach everyone by Jan. 1.

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Normally, insurers require payment for coverage before the coverage begins. They count an enrollment as complete only when the first month’s premium has been received from a customer. As of Monday, however, only about half of enrollees billed for plans offered by more than 100 insurers in 17 states had paid their first month’s premium, said Mark Waterstraat, chief strategy officer at Benaissance, a third-party billing firm that works for those insurers.

“There’s definitely going to be a period of confusion, until people do pay their premiums and their coverage is turned on,” Waterstraat said.

Unless they have paid the initial premium, most consumers would have to foot the entire bill for doctor’s office visits or prescription medications and would be reimbursed later.

After the federal government extended the deadline to sign up for coverage from Dec. 15 to Christmas Eve, most insurers in turn extended their deadlines for payment, some as late as Jan. 10 for coverage starting Jan. 1. Some, like Independence Blue Cross, a Philadelphia-area insurer, pushed the deadline as far back as Jan. 28. Humana Inc. said Monday that it would accept payments as late as Jan. 31.

Independence Blue Cross is pre-emptively sending insurance cards to consumers before they have paid, said Brian Lobley, a senior vice president. The insurer dispatched 20 workers over the weekend to create the plastic membership cards and ship them to presumptive enrollees. The plans won’t be “active” until the new customers actually pay Independence, but mailing the cards early will allow them to start using their plans right away once they have paid, Lobley said.

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